Del. Karen Lewis Young (D-Frederick) has withdrawn a bill that would create a study of Maryland’s surgical birth rate.

Maryland has a higher surgical birth rate, at 35 percent, than the national average, which caused concern for Lewis Young and other patient safety advocates. She said she withdrew the bill because the Maryland Patient Safety Center already collected data on the surgical birth rate and agreed to conduct a study on surgical births, including subsequent births.

“And you don’t always have to have a bill to get something done,” Lewis Young said. “If you can find another way, all the better.”

Once Robert Imhoff, president and CEO of Maryland Patient Safety Center, agreed to take over the study, Lewis Young withdrew the bill, she said.

The center collected data from 31 of the 32 birthing hospitals in Maryland, Imhoff said. Although they did not look at the cause and effect of why Maryland’s cesarean section, or surgical birth, rate was so high, they looked at ways hospitals could and were working to reduce the rate, he said.

C-sections can have additional medical risks, and although they can be necessary, there are concerns that Maryland’s rate is higher than it would be with only medically necessary surgical births.

“We’re not talking about eliminating C-sections. As I say, there [is] medical necessity around them,” Imhoff said.

The rates and reasons for C-sections varied by hospitals, said nurse Bonnie DiPietro, director of operations at the patient safety center, “but all of them were monitoring their C-section rate before we started.”

DiPietro said she was interested that hospitals such as St. Mary’s Hospital in Leonardtown, which has an active midwifery program, had lower surgical birth rates.

There is a need for education about C-sections, she said, because patients ask for elective C-sections. That’s something that can be done by obstetricians and prenatal care centers or at the hospital once a person is in labor and delivery.

The details of the study have not been worked out yet, Imhoff and Lewis Young said.

DiPietro said there is plenty more to study, including items recommended by the Alliance for Innovation on Maternal Health. That includes when a person should be admitted to the hospital during labor. The longer a person labors at a hospital, the more likely they’ll undergo a surgical birth.

“And so the question becomes which one of those items, is there a magic bullet on one of them,” she said.

This is not the first time Lewis Young has withdrew a bill because of finding another way to accomplish the task laid out in the proposed legislation, she said.

“And sometimes we’re better off that way. ... In the long run, it can be more efficient when we resolve it outside of legislation,” she said.

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Heather Mongilio is the health and Fort Detrick reporter for the Frederick News-Post. She can be reached at

(4) comments


Jeez Karen, so what! Medical decisions are between a woman and her doctor. They discuss the advantages and risks beforehand on voluntary c-sections. Surgically necessary c-sections are beyond your purview. MYOB!


This is Maryland. Annapolis can't help themselves from proposing unnecessary stuff. At least she withdrew the bill before it took up more time.


MD has one of the highest C-section rates in the country. Too many C-sections are being done for physician conveniece or malpractice concerns. Patients should have more of a say. We need to find out why MD has such high C-section rates (33% when the recommended average is 15%). Advocates/constituents asked for this study. It is the responsibility of a legislator to pay attention to constituent requests.


Huh? What constituents ever requested you to do this? And what do you propose? Doctors or patients asking the government for permission for a legal medical procedure? As I said above, all procedures are discussed beforehand, including the risks to the mother in future births (VBAC). The patient also signs an informed consent. That should be all you care about. Does Maryland have a higher rate of complications? Not from what I have seen. If you have different information, please provide a reference.

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